CONFIRMATION
POSITIVE
for 1 Ab
Serum Confirmation*
* Reference lab: CLIA-approved laboratory,
ideally IASP participant, which is able to
measure all 4 Ab: GAD65A, IA-2A, Insulin,
ZnT8A.
Obtain Random Blood Glucose (RBG) and HbA1c
Follow / monitor for medical safety and progression to T1D
Normal RBG <140 mg/dL
and HbA1c ≤ 5.6%
RBG 140-199 mg/dL
OR HbA1c 5.7-6.4%
RBG ≥ 200 mg/dL
OR HbA1c ≥ 6.5
• Educate for symptoms of
hyperglycemia
​
• Repeat Ab at reference lab*
in 1 year
Higher Intensity follow-up
• Assess/Educate for
symptoms of hyperglycemia
​
• Instruct on HGT 3**
• Referral to pediatric/adult
diabetologist
• Evaluate for symptoms of
hyperglycemia and ketosis***
• Verbal consult with and urgent
referral to pediatric/adult
diabetologist
* Reference lab: CLIA-approved laboratory, ideally IASP participant, which is able to measure all 4 Ab:
GAD65A, IA-2A, Insulin, ZnT8A.
​
**HGT (Home Glucose Testing) Protocol:
HGT1 (Level 1): Test 2 hours after largest meal of day once monthly
HGT2 (Level 2): Test 2 hours after largest meal of day once weekly
HGT3 (Level 3): Test 2 hours after largest meal of day for 5 days and send in numbers.
After initial assessment, test 2 hours after largest meal of day once weekly.
***Ketosis symptoms: vomiting, nausea, abdominal pain, Kussmaul breathing, altered mental status.
If concern for ketosis, check urine or blood ketones if able, if positive or unable to test refer for
urgent evaluation at ED.
This program was developed independently
by the Barbara Davis Center for Diabetes and supported in part by a grant from Sanofi US.
Version 2.0_6.2024